慢性乙型肝炎肝星状细胞形态改变与肝脏微循环障碍的关系

目的研究慢性乙型肝炎肝星状细胞形态改变与肝脏微循环障碍的关系。方法采用光镜观察肝星状细胞内脂滴数和体密度的变化，同时采用透射电镜观察肝星状细胞超微结构的变化和肝窦微循环结构的改变。结果慢性乙型肝炎肝星状内脂滴数减少，典型肝星状细胞数量减少，过渡型肝星状细胞数量增多，超微结构显示核被膜表面不规则，胞质内粗面内质网明显增多，多扩张，内有中等电子密度的絮状物质，高尔基复合体发达，细胞周围胶原原纤维量明显增多。肝窦内皮细胞窗孔减少变小，有的肝窦内皮细胞内出现WP（Weibel—Paladebody）小体。狄氏腔中胶原纤维沉积增多，肝窦内皮细胞下有基底膜形成。结论肝星状细胞激活后形态改变是肝脏微循环障碍的重要促进因素。

The relationship between the morphous changes of hepatic stellate cells and liver microcirculatory disturbance in patients with chronic hepatitis B

Objective To study the relationship between the morphous changes of hepatic stellate cells(HSCs) and liver microcirculatory disturbance in patients with chronic hepatitis B.Methods The number of lipid droplets and the changes of bulk density in hepatic stellate cells were observed by light microscope.Ultrastructure of HSCs and the changes of microcirculation of sinus hepaticus were observed by transmission electron microscope(TEM).Results In patients with chronic hepatitis B,the number of lipid droplets in hepatic stellate cells and typical HSCs reduced,while transitional HSCs increased.The surface of nuclear envelop showed anomalism;Rough endoplasmic reticulum intracytoplasm increased obviously,most of which expanded,and middling electron density floccule could be observed.Golgi complex became prosperous.Collagenous fibril around the HSCs turned more notably.Decreased sizes and reduced numbers of sinusoidal endothelial cells’(SECs) penestrate and collagen deposited in Disse space.Basal lamina could be found on SECs and WP(Weibel-Palade) bodies were found in SECs.Conclusion The morphous changes of HSCs after being stimulated is an important promoting agent to liver microcirculation disturbance in patients with chronic hepatitis B.